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CC BY 4.0 · Journal of Child Science 2021; 11(01): e245-e249
DOI: 10.1055/s-0041-1735536
Case Report

Expanding the Spectrum of EEG Periodic Discharges in Subacute Sclerosing Panencephalitis: A Case Report

Iliyana Aleksandrova 
1   Clinic of Child Neurology, MHATNP “St. Naum,” Sofia, Bulgaria
2   Department of Neurology, Medical University - Sofia, Sofia, Bulgaria
,
Asya Asenova
1   Clinic of Child Neurology, MHATNP “St. Naum,” Sofia, Bulgaria
2   Department of Neurology, Medical University - Sofia, Sofia, Bulgaria
,
Daniela Deneva
1   Clinic of Child Neurology, MHATNP “St. Naum,” Sofia, Bulgaria
2   Department of Neurology, Medical University - Sofia, Sofia, Bulgaria
,
Veneta Bojinova
1   Clinic of Child Neurology, MHATNP “St. Naum,” Sofia, Bulgaria
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Abstract

Background Atypical electroencephalogram (EEG) abnormalities emerge in patients with subacute sclerosing panencephalitis (SSPE), especially in cases with an atypical clinical presentation that can lead to diagnostic difficulties.

Case Report In this article, we presented a case of SSPE with an atypical onset with epileptic seizures and Parkinson's features. The neurological examination during the initial evaluation of the patient showed extrapyramidal syndrome, hyperreflexia, intention tremor, and dysmetria. Cranial magnetic resonance imaging was normal. Video EEGs were performed in wakefulness and sleep. In wakefulness, multiple brief seizures (1–1.5 seconds were recorded, consisting of gradual bending of the body forward and to the right that lacked the sudden characteristic of myoclonia. During those episodes, we recorded generalized epileptiform activity of 4 or 5 sharp waves, with higher amplitude in the anterior regions, in some of the paroxysms superimposed on a slow wave or followed by a high amplitude slow wave. The paroxysms appeared periodically every 15 to 30 seconds. However, 2 months later, the EEG showed typical periodic generalized activity of biphasic/triphasic slow waves (Radermecker complexes), accompanied by myoclonias.

Conclusion We reported a peculiar EEG pattern in a patient with SSPE that consists of periodic generalized activity of sharp waves. Atypical EEG patterns can appear when the disease progresses, but initially too, before typical periodic complexes and can complicate the diagnostic process.

Keywords

EEG periodic discharges - subacute sclerosing panencephalitis - measles

Authors' Contributions

I.A. and V.B. involved in study conception and design. I.A. and A.A. supported in data collection. I.A. and D.D. dedicated to analysis of the EEG and supervised the manuscript preparation. All authors reviewed the results and approved the final version of the manuscript.




Publication History

Received: 11 May 2021

Accepted: 25 July 2021

Article published online:
28 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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